Epigastric pain after meals and at night. Ultrasound showed no abnormalities.
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Scarry deformation of the duodenal bulb and pars superior. Thick-walled lesion with a central crater containing an air inclusion. Unsharp borders and thickening of the lateral duodenal wall with stranding of the periduodenal fat.
The lesion was later confirmed endoscopically. Biopsies were negative for malignancy.